U.S. patent application number 15/623320 was filed with the patent office on 2017-10-05 for integration of surgical instrument and display device for assisting in image-guided surgery.
The applicant listed for this patent is Brainlab AG. Invention is credited to Timo Neubauer, Gregor Tuma.
Application Number | 20170281297 15/623320 |
Document ID | / |
Family ID | 40427272 |
Filed Date | 2017-10-05 |
United States Patent
Application |
20170281297 |
Kind Code |
A1 |
Tuma; Gregor ; et
al. |
October 5, 2017 |
INTEGRATION OF SURGICAL INSTRUMENT AND DISPLAY DEVICE FOR ASSISTING
IN IMAGE-GUIDED SURGERY
Abstract
The invention relates to a surgical instrument comprising a
handle portion or mounting portion and a functional portion and/or
tip, wherein a display device is provided on the instrument and
includes or enables displays which serve to assist in image-guided
and/or navigation-assisted surgery. It also relates to a method for
navigating a surgical instrument, wherein its position is
determined and tracked by means of a medical tracking system and
the position data is processed within the framework of medical
navigation by means of a medical navigation system, wherein
displays for navigation assistance and/or for assisting in
image-guided surgery are provided on the instrument or on an
element which is positionally assigned to the instrument or
fastened to the instrument.
Inventors: |
Tuma; Gregor; (Munich,
DE) ; Neubauer; Timo; (Neukeferloh, DE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Brainlab AG |
Munich |
|
DE |
|
|
Family ID: |
40427272 |
Appl. No.: |
15/623320 |
Filed: |
June 14, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13845943 |
Mar 18, 2013 |
9730680 |
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15623320 |
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12581233 |
Oct 19, 2009 |
8734432 |
|
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13845943 |
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61107849 |
Oct 23, 2008 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 46/10 20160201;
A61B 2090/3983 20160201; A61B 2090/372 20160201; A61B 2090/065
20160201; A61B 2017/0023 20130101; A61B 2034/2048 20160201; A61B
2034/2051 20160201; A61B 90/39 20160201; A61B 2034/252 20160201;
A61B 2017/00477 20130101; A61B 2034/2055 20160201; A61B 2034/2065
20160201; A61B 2034/2068 20160201; A61B 2017/00128 20130101; A61B
2017/00199 20130101; A61B 2090/0818 20160201; A61B 17/00 20130101;
A61B 34/20 20160201 |
International
Class: |
A61B 17/00 20060101
A61B017/00; A61B 34/20 20160101 A61B034/20; A61B 90/00 20160101
A61B090/00 |
Foreign Application Data
Date |
Code |
Application Number |
Oct 21, 2008 |
EP |
08167095 |
Claims
1. Apparatus for use with an associated tracking camera system (2)
determining and tracking a position of the apparatus, the apparatus
comprising: a surgical instrument (10, 20, 30, 40, 60) comprising:
a handle and/or mounting portion (11, 21, 31, 41, 61); and a
functional and/or tip portion (19, 29, 39, 49, 69); an adaptor (41,
61, 71); and a portable integrated navigation system (45, 55, 75)
removably attachable with the surgical instrument via the adaptor,
the portable integrated navigation system being in operative
communication with the associated tracking camera system (2) and
comprising: a processor processing position data received by the
portable integrated navigation system from the associated tracking
camera system (2), the position data being representative of the
position of the apparatus determined and tracked by the associated
tracking camera system (2); and a display device (13, 23, 33, 43,
63, 73) comprising an image display selectively displaying visual
navigation assistance information related to the position data
received by the portable integrated navigation system to assist an
associated human using the apparatus in at least one of an
image-guided and/or a navigation-assisted procedure.
2. The apparatus according to claim 1, further comprising: one or
more markers (42, 62, 72) held in a fixed position relative to the
surgical instrument, the one or more markers (42, 62, 72) being
operable to provide a target to the associated tracking camera
system (2) for the associated tracking camera system (2)
determining and tracking the position of the apparatus.
3. The apparatus according to claim 2, wherein: the one or more
markers (42, 62) are held in the fixed position relative to the
surgical instrument when the portable integrated navigation system
is selectively attached with the surgical instrument via the
adaptor; and
4. The apparatus according to claim 3, wherein: the one or more
markers (42, 62) comprise an exterior outline of the display
device.
5. The apparatus according to claim 2, wherein: the one or more
markers (72) are rigidly attached with the adaptor.
6. The apparatus according to claim 5, wherein: the adapter
comprises a mounting portion (71) configured to selectively receive
the portable integrated navigation system and hold the portable
integrated navigation system in a predefined fixed position
relative to the functional and/or tip portion (79) of the surgical
instrument.
7. The apparatus according to claim 2, wherein: the display device
comprises one or more indicators which can be highlighted.
8. The apparatus according to claim 7, wherein: the one or more
indicators which can be highlighted comprise one or more symbols or
characters which can be illuminated or back-lit
9. The apparatus according to claim 2, wherein the portable
integrated navigation system (45, 55, 75) further comprises: an
integrated inertial sensor system, the integrated inertial sensor
system generating tracking data for use by the processor of the
portable integrated navigation system, the tracking data being
representative of tracking information of the apparatus relative to
the at least one of the image-guided and/or the navigation-assisted
procedure.
10. The apparatus according to claim 9, wherein the processor of
the portable integrated navigation system is operable to process
the tracking data generated by the integrated inertial sensor
system together with redundant Kalman filtering for 3D localization
of the apparatus relative to the at least one of the image-guided
and/or the navigation-assisted procedure.
11. The apparatus according to claim 2, wherein: the functional
and/or tip portion of the surgical instrument comprises a fastening
portion for fixing the instrument to an associated workpiece.
12. The apparatus according to claim 2, wherein: the functional
and/or tip portion of the surgical instrument comprises a
calibration receptacle which comprises a counter piece for an
object to be aligned with the instrument.
13. The apparatus according to claim 2, further comprising: a
sterile drape and/or shell member selectively covering the portable
integrated navigation system.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. application Ser.
No. 13/845,943, filed on Mar. 18, 2013, which is a continuation of
U.S. application Ser. No. 12/581,233 filed on Oct. 19, 2009, now
U.S. Pat. No. 8,734,432, which claims the benefit of U.S.
Provisional Application No. 61/107,849, filed on Oct. 23, 2008,
each of which is hereby incorporated in their entirety by
reference.
FIELD OF THE INVENTION
[0002] The invention relates to the integration of surgical
instruments and display devices (and, in specific embodiments, also
a computational unit) for assisting in image-guided surgery. In
particular, it relates to a surgical instrument comprising a handle
portion or mounting portion and a functional portion, and to a
method for navigating a surgical instrument. In specific
embodiments of the present invention, the surgical instrument is a
pointing instrument--a so-called pointer.
BACKGROUND OF THE INVENTION
[0003] The functional portion mentioned is the portion with which
the instrument is equipped in accordance with its task, i.e. for
example a pointer tip in the case of a pointer instrument, a
cutting edge in the case of a scalpel, or a fastening portion (the
fastening portion is suitable for enabling the instrument to be
attached elsewhere, in particular to other medical instruments, for
example to a cutting block, an implant, a fraise, a saw, a drill, a
chisel, a screwdriver, etc.) or a forcipate portion in the case of
a pair of tweezers. It can also be or include a calibration
receptacle which comprises a counter piece for an object to be
aligned, for example in order to quickly register an image data set
using a scanned counter piece. In everyday parlance, these
functional portions are often also referred to as a "tip" of the
instrument, and the term "tip" is also used here in this sense. It
can thus also describe functional portions of instruments which are
not physically embodied as a tip or embodied to be pointed.
[0004] Within the framework of navigation-assisted and/or
image-guided surgery, the aforementioned pointers are in many cases
used to register a patient, wherein a spatially tracked pointer is
moved to various points and/or landmarks on the patient, in order
to determine the spatial position of these points and/or landmarks
in the navigation coordinate system of a treatment room. These
points or landmarks are then assigned to corresponding points or
landmarks provided in an image data set (CT, MRI, etc.) acquired
for example before the treatment, and stored in the navigation
system. On the basis of this, it is then possible to perform the
navigation-assisted and/or image-guided treatment. In many cases,
the instruments--i.e. including the pointer--are spatially tracked
by optical tracking systems, wherein markings (tracking markers)
attached to the instruments are tracked by cameras.
[0005] This sequence of registration steps is rather painstaking to
complete using tracked pointer instruments in accordance with the
prior art and conventional navigation systems, because the person
performing the treatment has to constantly change their angle of
view. In order to see which step follows as the next step in the
registration procedure, it is necessary to look at the navigation
monitor, while in parallel with this, the landmark on the patient
is sought. In order to ensure that the landmark has been acquired,
the surgeon again has to look at the monitor or wait for a
confirmation signal. If a number of points or a point cloud (when
acquiring surfaces) have to be scanned, the situation becomes even
more difficult because the correct position of the pointer has to
be verified again and again with the aid of the monitor--which is
usually far away from the working environment.
SUMMARY OF THE INVENTION
[0006] It is an object of the present invention to facilitate the
handling of a surgical instrument in the navigation environment,
and in particular to make the surgeon's interaction with the
instrument in the navigation environment simpler. This also applies
specifically to registration tasks.
[0007] This object is solved in accordance with the invention by a
surgical instrument comprising a handle portion or mounting portion
and a functional portion and/or tip, wherein a display device is
provided on the instrument and includes or enables displays which
serve to assist in image-guided and/or navigation-assisted surgery,
and by a method for navigating a surgical instrument, wherein its
position is determined and tracked by means of a medical tracking
system and the position data is processed within the framework of
medical navigation by means of a medical navigation system, wherein
displays for navigation assistance and/or for assisting in
image-guided surgery are provided on the instrument or on an
element which is positionally assigned to the instrument or
fastened to the instrument. The sub-claims define preferred
embodiments of the invention.
[0008] The surgical instrument in accordance with the present
invention, which comprises a handle portion or mounting portion and
a tip, has a display device provided on it which includes or
enables displays which serve to assist in image-guided and/or
navigation-assisted surgery, i.e. in other words, the instrument
itself displays information to the surgeon which he needs during
the course of the treatment, such that the surgeon does not have to
look away from the instrument and/or patient in order to be able to
work with navigational assistance, wherein a registration method is
for example assisted in such a way that the work can proceed far
more intuitively during the landmark acquisition sequence. Pointers
or pointing apparatuses which are embodied in accordance with the
invention can not only positionally acquire landmarks or points but
can also provide information concerning the location of the
landmark itself. The surgeon can concentrate his attention on the
treatment location, i.e. on the incision environment, and is not
distracted by looking towards the monitor.
[0009] The display device can exhibit many different configurations
within the framework of the present invention. On the one hand, it
can include one or more indicators which can be highlighted, in
particular symbols or characters which can be illuminated or
back-lit. On the other hand, it can for example comprise an image
display, in particular a screen display, which can be embodied in
many different forms, wherein high-resolution color monitors or
also energy-saving LCD image displays are possible. In very general
terms, it may be said that what is important within the framework
of the invention is for the display to provide information to the
physician who would otherwise have to look at the monitor. This can
also include illuminated displays which are formed as points or
strips and for example communicate load cases using red-amber-green
displays.
[0010] In one embodiment in accordance with the invention, the
position of the surgical instrument can be determined and tracked
by means of a medical tracking system, wherein the position data is
processed within the framework of medical navigation by means of a
medical navigation system. One particular embodiment of such a
tracking system (in addition to optical and magnetic tracking
systems) is an integrated sensor system, specifically an inertial
sensor system, which provides tracking information.
[0011] In one embodiment variant of the invention, a data processor
is integrated in the instrument and assigned to the display device,
wherein the activity of the instrument is tracked and identified by
means of the data processor, i.e. in other words, it is also
perfectly possible to evaluate the navigation and tracking data in
the instrument, wherein said navigation and tracking data can in
turn be provided to the surgeon via the display device.
[0012] The display device can be provided integrally with the
instrument or can be able to be integrated into the instrument
and/or attached to the instrument, specifically via an adaptor.
[0013] Instruments in accordance with the present invention can be
provided with tracking markings; these tracking markings can in
particular also be attached in the region of the display device or
attached to the display device. This includes the scenario in which
reflection markers or infrared LEDs are rigidly fastened to the
instrument, for example two or three tracking markers in a fixed
geometric (characteristic) arrangement with respect to each
other.
[0014] Providing such marker arrays and/or reference arrays is
however elaborate and requires calibration steps. Tracking on the
basis of the shape of an object alone is in turn not robust enough
against distortions in the images, background or contrast, etc.
[0015] The present invention then ensures that this is remedied,
using an embodiment of the surgical instrument in which the display
itself displays tracking markings or itself represents tracking
markings or a tracking marking. In other words, a surgical
instrument or tracking reference (for example a bone tracker) is
provided in accordance with this embodiment of the invention, which
can be automatically tracked or the display contents of which are
tracked. This removes the need to attach tracking markings, but the
tracking will nonetheless still be robust enough in order to
positionally track the instrument continuously and reliably using
the display device, since the display can easily be made bright
enough to ensure that it is detected by the camera system. It can
also be made clear enough by being colored, shaped or patterned.
If, for example, the dimensions of the rectangular screen are known
in the navigation system, it is possible to determine the alignment
and position from the distortion in the angle of view in relation
to a point of interest on the instrument or in relation to the
anatomical structure. It may also be possible to directly match the
display information, since it can be clearly described. The unit in
which the tracking markings are displayed on the display device
will also be capable of automatically or manually changing the
tracking pattern, in order to adapt to particular tracking
situations or to assign different instruments to different specific
tracking patterns which can then be tracked in parallel.
[0016] In one embodiment in accordance with the invention, the
display device includes the navigation image display. This
embodiment in accordance with the invention enables the physician
to perform the entire navigation with image assistance, without
once having to look away from the working environment in which the
instrument is situated.
[0017] It is possible to also provide the data processor of the
navigation system integrally with the instrument or to enable it to
be integrated into the instrument and/or attached to the
instrument, specifically via an adaptor. The physician would then
have a portable navigation system comprising a display and a data
processor on his instrument; providing the other navigation
components would be limited to providing the camera tracking system
or an equivalent tracking system (magnetic tracking, etc.) and/or
would even be completely omitted, i.e. if the navigation system is
an inertial system which operates using acceleration, inertia
and/or angle sensors integrated in the instrument, i.e. in such
cases, the integrated data processor can assume the function of
evaluating an inertial sensor system in the instrument, in
particular also in connection with external and additional or
redundant tracking information (for example, Kalman filtering), in
order to improve 3D localization.
[0018] One embodiment of an instrument in accordance with the
invention is characterized in that the data processor and the
display device are provided as an integrated, specifically portable
navigation system. This integrated system, in particular the
integrated navigation system, can be able to be removably attached
to the handle portion or mounting portion of the instrument via an
adaptor. If the display device is directly tracked, the tracker is
for example on the display and the adaptor has no tracker; if it is
tracked for example via marker spheres, these are either on the
display device or on the adaptor. Adapting is preferably performed
in a known spatial assignment of the instrument and the adaptor
with respect to each other and can be reproducibly released and
reconnected.
[0019] The instrument can have a functional instrument tip as its
tip (for example, a pointer instrument); it is however also
possible to provide a fastening portion, for fixing the instrument,
as the tip, such that the instrument itself then becomes a tracker
(a tracking marking/reference) which can for example be fastened to
a bone.
[0020] The method in accordance with the invention serves to
navigate a surgical instrument, in particular an instrument such as
has been described above in various embodiments. The position of
the instrument is determined and tracked by means of a medical
tracking system and the position data is processed within the
framework of medical navigation by means of a medical navigation
system, wherein displays for navigation assistance and/or for
assisting in image-guided surgery are provided on the instrument or
on an element which is positionally assigned to the instrument or
fastened to the instrument.
[0021] When landmarks or surfaces are acquired and registered using
the instrument, which serves as a position indicator and/or
pointer, the display device can predetermine and assist in the
selection of the landmarks and/or surfaces. This also applies in
principle to the sequence of acquisition.
[0022] It is in principle possible to control the display device
using the data processor which determines movements or point
acquisitions with the aid of the navigation system or using sensors
on the instrument. It is also possible to determine movements or
point acquisitions with the aid of a defined movement of the
trackers with respect to each other.
[0023] The visual navigation assistance can be output via a display
device which is formed as a screen, and the display device can
display changing tracking markings, as already described above. It
is also possible within the framework of invention for the visual
navigation assistance via the display device to simultaneously show
the tracking markings.
[0024] The instrument in accordance with the invention can be
configured such that the display device--or a navigation system
which is integrated in the instrument and can include the display
device--is provided as a separate element which can be attached to
the instrument and comprises a sterile covering, in particular a
sterile drape or a shell which is sterile and/or can be sterilized.
It is also conceivable for the handle portion or mounting portion
and/or the functional portion and in particular also components of
the instrument which are attached to them to be formed as sterile
disposable items, in particular as sterilely packaged disposable
items, specifically made of a plastic material.
[0025] The embodiments of the method in accordance with the
invention exhibit at least all the advantages which have already
been described above with regard to the implementations of the
invention as a device.
BRIEF DESCRIPTION OF THE DRAWINGS
[0026] The invention is explained below in more detail on the basis
of the enclosed drawings and by referring to various embodiments.
It can include any of the features described here, individually and
in any expedient combination, which can represent a method, a
device or a use.
[0027] FIGS. 1 to 3 show pointer instruments embodied in accordance
with the invention, comprising different display devices.
[0028] FIGS. 4 and 5 show pointers in accordance with the
invention, comprising a navigation screen which also serves as a
tracking reference.
[0029] FIG. 6 shows an embodiment of the invention as a bone
tracker.
[0030] FIG. 7 shows an instrument in accordance with the invention,
as a portable navigation system comprising a disposable mounting
(sterile solution).
[0031] FIG. 8 shows another embodiment of a sterilely packaged,
portable navigation system.
DETAILED DESCRIPTION
[0032] In FIGS. 1 to 7, the surgical instruments have been provided
in very general terms with the reference signs 10, 20, 30, 40, 50,
60 and 70, respectively. The handles of the instruments 10, 20 and
30 bear the reference signs 11, 21 and 31, while the mounting
portions of the instruments 40, 50, 60 and 70 have the reference
signs 41, 51, 61 and 71, respectively. The latter mounting portions
41, 51, 61 and 71 are provided as adaptor mountings for display
units and/or data processing units, in particular portable
navigation systems 45, 55, 65, 75; they can, however, also be fixed
mountings. Throughout the figures, the displays bear the reference
signs 13, 23, 33, 43, 53, 63 and 73, respectively, and markers
and/or tracking markings are indicated by 12, 22, 32, 42, 52, 62
and 72, respectively. In FIGS. 1 and 3, the reference signs 14 and
34 indicate buttons on the instrument which influence the display
or enable inputs on the instrument which can also be relayed to an
external navigation system.
[0033] In FIG. 2, the reference sign 24 indicates a sprung mounting
of the instrument tip 29. The spring presents the possibility of
automatically recording a point which is made known to the tracking
system by shifting marker spheres with respect to each other in a
defined way or by a force sensor system.
[0034] The instrument tips 19, 29, 39, 49 and 59 are embodied as
pointer tips in FIGS. 1 to 5, while FIG. 6 shows an instrument tip
69 which comprises a fastening means at its distal end. The
reference signs 12, 22 and 32 in FIGS. 1 to 3 indicate spherical
reference markers, the reference sign 42 in FIG. 4 indicates the
exterior outline of the image display 43, and the reference sign 52
in FIG. 5 indicates reference markers which are generated on the
image display 53. A tracking camera 2, comprising two individual
cameras, and a bone 4 are also shown in each of FIGS. 4, 5 and 6; a
reference array 6 comprising reference markers for the bone (bone
trackers) is also shown in FIGS. 4 and 5, and FIG. 6 also shows an
additional pointer instrument 8.
[0035] In the following, reference shall initially be made to FIGS.
1 to 3, in each of which a display 13, 23, 33 is provided which
communicates instructions to the physician as to where a point on
the patient's anatomy is to be acquired in a registration
procedure. This could be achieved either by graphic representations
or text (FIG. 1) or in conjunction with a display which shows
whether the landmark still has to be acquired or has already been
acquired. The latter applies for example to the back-lit button
displays in FIG. 2, in which for example a button which is back-lit
in red indicates that a certain landmark still has to be acquired
and a button which is back-lit in green means that the landmark has
already been acquired. The display can also give instructions--as
in FIG. 3--as to how many points have already been acquired or the
proportion of the total points which have already been acquired so
far (bar display). This tells the user where and how many points
and/or point clouds still have to be traveled using the pointer
tip, in order for example to register a bone surface, i.e. in
particular for morphing or surface matching using an image data
set.
[0036] The pointer instruments shown in FIGS. 1 to 3 use reflective
tracking markers 12, 22, 32 which can be detected by a tracking
system (for example, an infrared camera system). It is possible to
use other tracking technologies, for example tracking active LED
markers, electromagnetic tracking or acoustic tracking.
[0037] The pointer instruments in accordance with the present
invention can not only comprise displays but can also be equipped
with a data processing unit which is software-controlled and can
detect the acquisition of a point or point cloud autonomously
and/or with the aid of the navigation system. Inertia-acceleration
sensors could for example detect the current algorithmic
integration of a pivoting movement of the pointer in order to
acquire the point, and consequently switch the representation on
the display forwards from one registration screen to the next. The
discrete displays of the embodiment according to FIG. 2 could be
controlled in a similar way. In this case, further communication
with the navigation system is no longer necessary, but can
optionally be provided and realized by the buttons 14, 34. Another
way of realizing this would be to shorten the distance between the
two marker spheres 22 in the embodiment according to FIG. 2 if a
point is indicated by the tip 29, wherein the tip is sprung towards
the handle (sprung-mounted 24).
[0038] FIGS. 4 to 6 each show how a navigation system is provided
which consists of a data processing unit and display unit 45, 55,
65 and an externally provided tracking camera 2. It is conceivable
for an external tracking system to be (partially) omitted if the
data and display unit is equipped with an inertial sensor system,
wherein the units 45, 55 and 65 can be discrete, separate and
completely integrated navigation units and/or display units. They
are fastened to the instrument via adaptor mountings 41, 51 and 61.
In the case of FIGS. 4 and 5, the instrument has a pointer tip 49,
59; in the case of FIG. 6, the tip 69 mounts the instrument on the
bone 4. Navigation information or user instructions are displayed
by the navigation units 45, 55 and 65, and this could be achieved
either by graphic representations or text information. In order
that the instruments can be positionally tracked in space using the
optical tracking system 2, the outline 42 of the screen and/or
display 43 and its three-dimensional alignment are detected by the
camera system 2 in the embodiment according to FIG. 4.
[0039] Alternatively, the tracking markers 52 are shown directly on
the display 53 in the embodiment in accordance with FIG. 5, i.e. it
is possible to generate specific patterns which generate "virtual
markers". The display itself can be a pattern, since the display is
defined at least in partial aspects by the programming of the
graphic user interface. The increase in robustness by using known
graphic representations can also mean that normal cameras (instead
of infrared cameras) can be used. These solutions in accordance
with the invention allow the information display to be combined
with the tracker units within the line of sight to the tracking
system 2. It is no longer necessary to additionally attach tracking
markers.
[0040] While the two instruments 40, 50 in FIGS. 4 and 5 can serve
as pointer instruments for registering landmarks, wherein the
patient's anatomy is also separately tracked (the bone 4 comprising
the tracking reference 6), the tracking system itself can be
fastened to the instrument and via the instrument to the bone 4 in
accordance with the embodiment according to FIG. 6. This enables
the bone 4 to be tracked via the instrument 60 itself, using the
rectangle of the display (see FIG. 4) or via superimposed markers
(see FIG. 5). The instrument 60 comprising the navigation and
display system 65 thus serves both as a tracking reference and as a
display for the surgeon, and an additional pointer instrument 8 can
be simultaneously tracked.
[0041] In all cases, the surgeon performing the treatment can
obtain all the navigation information without constantly having to
look away from the working environment, to look at a separate
navigation monitor.
[0042] FIGS. 7 and 8 illustrate "sterile solutions" in accordance
with the invention, i.e. embodiments in which an instrument in
accordance with the invention comprising a display or a portable
navigation system attached to the display can be sterilely used in
a simple and uncomplicated way, with the aid of disposable
components for handle portions or mounting portions and/or for
functional portions (tip).
[0043] Using such embodiments in accordance with the invention, it
is possible to use a combination of a navigation system 75
(comprising a display 73), 85 and a surgical instrument 70 in a
sterile environment, wherein in the embodiment according to FIG. 7,
the holding means 71 and/or the tip 79 are (individually or both)
formed as disposable items (which can be used once), which can
themselves also bear navigation reference markers 72. This part of
the instrument would simply be provided, already sterilely
packaged, in the operation environment and can be disposed of after
it has been used once. It can consist substantially or completely
of plastic. The mounting portion 71 forms a framework into which
the portable navigation system 75 can be inserted; it also includes
reference markers 72, and all manner of instrument tips can be
attached to it (a pointer tip 79 is shown in this case). It can
however also be an L-shaped device attached to the mounting portion
71 (for registering the distal joint line and the posterior joint
line) or a cutting block.
[0044] In the embodiment according to FIG. 7, the portable
navigation system 75 comprising the display 73 has been wrapped in
a sterile drape (covering of film) before being inserted into the
mounting 71; this drape is indicated by a broken line and has been
given the reference sign 74. In this way, the navigation system 75
(comprising the display 73) is thus likewise sterilely provided and
can be directly used together with the other sterile elements of
the instrument. The instrument as a whole is embodied such that the
user can easily interact with the navigation system or the display
(for example, a touch-sensitive screen 73), while it is held in the
hand and used as a surgical instrument.
[0045] As shown in FIG. 8, the holding means can also comprise a
holding plate 81 comprising navigation markers 82, on which a
navigation system (comprising a display 85) is placed and which is
covered with a sterile, rigid covering (for example, a cover made
of a transparent plastic material). The navigation system can then
for example be operated via thinner points or areas of the covering
84 (also possible in the region of the screen) which it is possible
to press through.
[0046] All the parts of the instrument in accordance with FIG. 7 or
FIG. 8, produced in this way, can as a whole be provided as
disposable parts in accordance with the invention, including the
mounting portion, the instrument tip and the reference markings,
such that the instrument no longer requires a sterilizing effort.
This specifically applies when the sterile cover 83, 74 is also
provided as a disposable item.
[0047] Computer program elements of the invention may be embodied
in hardware and/or software (including firmware, resident software,
micro-code, etc.). The computer program elements of the invention
may take the form of a computer program product which may be
embodied by a computer-usable or computer-readable storage medium
comprising computer-usable or computer-readable program
instructions, "code" or a "computer program" embodied in said
medium for use by or in connection with the instruction executing
system. Within the context of this application, a computer-usable
or computer-readable medium may be any medium which can contain,
store, communicate, propagate or transport the program for use by
or in connection with the instruction executing system, apparatus
or device. The computer-usable or computer-readable medium may for
example be, but is not limited to, an electronic, magnetic,
optical, electromagnetic, infrared or semiconductor system,
apparatus, device or medium of propagation, such as for example the
Internet. The computer-usable or computer-readable medium could
even for example be paper or another suitable medium on which the
program is printed, since the program could be electronically
captured, for example by optically scanning the paper or other
suitable medium, and then compiled, interpreted or otherwise
processed in a suitable manner. The computer program product and
any software and/or hardware described here form the various means
for performing the functions of the invention in the example
embodiment(s).
[0048] Although the invention has been shown and described with
respect to one or more particular preferred embodiments, it is
clear that equivalent amendments or modifications will occur to the
person skilled in the art when reading and interpreting the text
and enclosed drawing(s) of this specification. In particular with
regard to the various functions performed by the elements
(components, assemblies, devices, compositions, etc.) described
above, the terms used to describe such elements (including any
reference to a "means") are intended, unless expressly indicated
otherwise, to correspond to any element which performs the
specified function of the element described, i.e. which is
functionally equivalent to it, even if it is not structurally
equivalent to the disclosed structure which performs the function
in the example embodiment(s) illustrated here. Moreover, while a
particular feature of the invention may have been described above
with respect to only one or some of the embodiments illustrated,
such a feature may also be combined with one or more other features
of the other embodiments, in any way such as may be desirable or
advantageous for any given application of the invention.
* * * * *